Objective This study was designed to explore the effect of hyperglycemia on the expression of Toll-like receptor 4 (TLR4 ) in renal tubular epithelial cells and its significance in diabetic nephropathy. Methods In vitro cultured renal tubular epithelial cells ( NRK-52E) were divided into LG group (cultured in 5mmol / L glucose DMEM) and HC group (cultured in 25mmol / L glucose DMEM). Cells were harvested at different time points. Immunohistochemistry, Rt-PCR, Western Blot were used to detect TLR4 protein and mRNA expression, and the levels of IL-6 and TNF-α from the cell culture supernatant were determined by EL1SA assay. Results After 6 hours, there was increased expression TLR4 mRNA in HC group, which appeared to be maintained for 24 hours and began to decrease after 48 hours ( P < 0.05). TLR4 protein expression increased in HC group after 24 hours, and increased even further after 48 hours. Compared with LG groups, the difference had statistical significance ( P <0.05). In HG group, IL-6 and TNF-α expression in the supernatant from the NRK-52E culture were significantly increased ( P < 0.05) , and the expression of IL-6 and TNF-α was positive correlated with the expression of TLR4 protein ( r =0.799,0.820). Conclusion High glucose triggers an increase in expression of TLR4 in NRK-52E cells, itself leading to an increase in expression of inflammatory factors such as TNF-α and IL-6. In this way, TLR4 participates in the progress of diabetic nephropathy.

Objective:To determine the plasma level of apelin in patients of maintenance hemodialysis (MHD) and to explore the relationship between apelin level and carotid atherosclerosis (AS) in MHD patients.Methods:A total of 92 MHD patients and 36 sex-and age-matched healthy subjects were enrolled in this study.The plasma level of apelin was evaluated by radiation immunoassay;serum endothelial injury markers including thrombomodulin,von Willebrand factor (vWF),and CD 146,and inflammatory factors including high sensitive C-reactive protein (hsCRP),IL-6 and TNF-α were determined by ELISA.Common Carotid arteries intima media thickness (CCA-IMT),cross-sectional calculated intima-media area (cIM area) area and atherosclerotic plaque were measured by non-invasive high-resolution B-mode ultrasonography.Results:The plasma levels of apelin was significantly decreased in MHD patients compared with healthy subjects (P＜0.01),accompanied with elevated plasma levels of thrombomodulin,vWF,CD 146,hsCRP,IL-6 and TNF-α (all P＜0.01).The plasma levels of apelinin in MHD patients with carotid artery plaques were obviously lower than those without plaques [(43.16± 10.12) pg/mL vs (61.43±16.25) pg/mL,P＜0.01].Plasma level of apelin was inversely related with CCA-IMT and cIM area (r=-0.355 and r=-0.297 respectively,all P＜0.01).Multiple stepwise regression analysis showed that plasma level of apelin was an independent risk factor for CCA-IMT and cIM area.Conclusion:The plasma apelin in MHD patients might take part in vascular endothelial injury and the progress of atherosclerosis.It plays an important role in the initiation and development of uremia associated atherosclerosis through elevating inflammatory factors including hsCRP,IL-6 and TNF-α levels.

AIM: To explore the mechanism and significance of the intestinal epithelial cellular membrane damage following burn serum. METHODS: The intestinal epithelial cell(IEC-6) were cultured. The changes of total membranous phospholipid contents fluidity of the IEC membrane were dynamically examined with fluorescence polarization technique and HPCE. RESULTS: In the early stage after stimulation by 20% burn serum, the membranous fluidity obviously decreased. The total phospholipid contents decreased, the content of PLA 2 markedly increased. CONCLUSION: The serial changes in IEC after burned could result in the damages of IEC membrane structure, the integrity of cell membrane and function.

Objective To summarize the experiences in laparoscopic inguinal hernia repairing for adult patients. Methods Clinical data of 512 hernia cases admitted in our center from March 2007 to Sep 2010 were retrospectively analyzed.There were 437 cases of single-sided hernia,including 281 indirect inguinal hernia,86 direct inguinal hernia,15 femoral hernia,16 combined inguinal hernia and 39 recurrent hernia.There were also 75 cases of double-sided inguinal hernia,including 3 recurrent hernia.There were 41 acute incarcerated hernia cases.The average postoperative follow up time was(29 ± 12) months. Results 507 cases underwent successful laparoscopic repair,and 5 cases were converted to open procedure.There were 238 TAPP and 269 TEP in laparoscopic operations.The average operative time for TAPP was (69 ±19) min,and (58 ±15) min for TEP.The average length of postoperative stay was (5.0 ± 1.5) days.The percentage of resuming normal activity after 2 weeks and 4 weeks were 95.7％ (485/507) and 99.0％(502/507).The most common postoperative complications were seroma (9.7％,49/507),transient paresthesia (4.1％,21/507) and chronic pain (0.8％,4/507).The recurrence rate was 0.6％ (3/507).Conclusions Laparoscopic repair of inguinal hernia has the advantage of less trauma,faster recovery,and lower recurrence rate.

Objectives To investigate the changes of cystatin C in the serum of patients with acute kidney injury ( AKI) or end-stage renal disease ( ESRD), and study its significance in the early diagnosis of AKI and its correlation with the degree of renal function injury. Method The cases in Xiangya hospital were enrolled in this study according to the RIFLE criteria, including 20 cases of slight acute kidney injury, 30 cases of medium-severe acute kidney injury, 48 cases of victims of the 5. 12 wenchuan earthquake, 32 cases of end-stage renal disease and 20 healthy patients. The microparticle-enhanced immunoturbidimetry method was used to detect serum cystatin C, and the colorimetric method was used to detect urine N-acetyl-beta-D-glucosaminidase (NAGase). The enzymic method was used to detect serum creatinine. The correlation between serum cystatin C and serum creatinine was analyzed, and the sensitivity and specificity of serum cystatin C were evaluated with the receiver operator characteristic curve (ROC curve). Results Compared with healthy control group, the serum cystatin C increased obviously in acute kidney injury group and ESRD group( P <0. 05 and P <0. 01). The serum cystatin C was positively correlated with serum creati-nine( P <0.01). The serum cystatin C in the 5. 12 wenchuan earthquake injured group was also higher than that in healthy control group ( P <0.05), an the serum cystatin C had an AUC - ROC of 0.931 ( P <0. 01). Conclusion Compared to the conventional biomarkers, the earlier emergence of serum cystatin C can contribute better to early clinical diagnosis of AKI. The serum cystatin C is positively correlated with renal function, and reflect changes in renal function accurately.

Objective To investigate the value of remnant stomach-jejunal dual pathways reconstruction after laparoscope-assisted radical proximal gastrectomy in the treatment of upper gastric cancer. Methods Twenty-five patients with upper gastric cancer underwent laparoscope-assisted radical proximal gastrectomy and the remnant distal stomach was preserved for side-to-side remnant stomach-jejunal anastomosis and end-to-side jejuno-jejunal anastomosis to reconstruct dual pathways. Results The mean operation time was (240±35) minutes, the mean number of lymph nodes dissected were 22±5, and all the incised margins were negative. No anastomotic leakage, obstruction or stenosis occurred. All patients received postoperative barium meal examination. A large amount of barium directly entered the jejunum, leaving a small amount of barium entered the jejunnum via the route of remnant stomach-duodenum, and was detained in the remnant stomach for 30-60 minutes. No esophageal reflux of barium was observed. All the patients were followed up for 4-18 months, no reflux esophagitis was detected and the short-term life quality was satisfactory. Conclusions Remnant stomach-jejunal dual pathways reconstruction prevents the reflux esophagitis and dumping syndrome, preserves the pathway of duodenum and promotes the life quality of patients.

In order to investigate the hygienic characteristic of anti-immersion trousers, ten male soldiers dressed in the trousers or in camouflage trousers were subjected to exercise test and sedentary test respectively at room temperature of 17?2℃. In the test, eleven parameters such as core temperature, skin temperature, heat flow and so on were observed. The results indicated that in sedentary tests, the low limb heat flow of the subjects dressed in anti-immersion trousers was larger than that dressed in camouflage trousers; the heat insulation value of anti-immersion trousers was smaller than that of camouflage trousers; and for the other parameters, there was no evident difference between the two group. It suggested that when used on land, hygiene characteristic and effect on body heat balance of the anti-immersion trousers were similar to those of camouflage trousers.

The relevant literatures of Siwu series decoctions--Taohong Siwu decoction for treating primary dysmenorrea of gynecology blood stasis syndrome were summarized including the clinical application, pharmacological effects, bioactive components and metabolic characteristics. On this basis,research on the bioactive components and formulation rule were discussed, to provide reference for modern traditional Chinese medicine formula study.
Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Dysmenorrhea ; drug therapy ; Female ; Humans

Objective To compare the traditional electrophysiological testing with modified methods for differential diagnosis of Radial Tunnel Syndrome (RTS).Methods A total of 87 selected patients were initially diagnosed as Lateral Epicondylitis (LE) or Tennis Elbow (TE) by doctors from the Outpatient Department of Orthopedics and Rehabilitation.Medical history was asked.Patients received physical examination and examinations for the sensory nerve action potential (SNAP) of superficial radial nerve,the compound muscle action potential (CMAP) of radial nerve and needle electromyography (EMG) to record the muscle Motor Unit Action Potentials (MUAPs).Then,the modified methods for CMAP of radial nerve were conducted on the forearm in the neutral,pronation and supination positions.Three values of CMAP latency were compared.RTS was diagnosed when the difference value ≥0.3 ms.The x 2 test was used to compare the positive detectable rates of the two methods for the RTS diagnosis.Results Thirteen out of 87 patients were diagnosed as RTS,among which three had interosseous nerve lesion and one had superficial radial nerve lesion.The traditional EMG failed to diagnose the remaining 9 RTS cases.These patients were finally diagnosed due to their latency difference of radial nerve CMAP ≥0.3ms when their forearms were examined in three positions.Conclusion The modified electrophysiology method shows a higher positive rate for the diagnosis of RTS.(P＜0.05).

Objective To evaluate the effect of sevoflurane anesthesia on the expression of phosphorylated cAMP response element-binding protein (p-CREB) in the hippocampal neurons of developing rats.Methods Thirty-two healthy male Sprague-Dawley rats, aged 7 days, weighing 10-15 g, were equally and randomly divided into either control group (group C) or sevoflurane anesthesia group (group Sev) using a random number table.Group C inhaled 30％ oxygen for 6 h.Group Sev inhaled 3％ sevoflurane for 6 h.Eight rats in each group were sacrificed immediately after the end of oxygen or sevoflurane inhalation, and the hippocampus was removed for determination of the expression of p-CREB.The rats at ages 2 months underwent Morris water maze test.The rats were then sacrificed, and the hippocampus was removed for determination of the expression of p-CREB by Western blot.Results Compared with group C, the escape latency and swimming distance were significantly prolonged, the frequency of crossing the original platform was decreased, the percentage of the time of staying at the quadrant Ⅱ was decreased, and the expression of p-CREB in hippocampal neurons was down-regulated in group Sev.Conclusion The mechanism of sevoflurane anesthesia-induced neurotoxicity is related to inhibition of p-CREB expression in hippocampal neurons of developing rats.